A good deal of balance is in your head, through the sensory experience known as proprioception, which is your body’s awareness of where its limbs are in space (without having to look). Proprioception, also referred to as kinesthetic awareness, is what allows you to do something like close your eyes and lift your hand to touch your nose. While such a movement requires muscular strength (to be able to lift your hand), it also requires good neural pathways so your brain can tell your hand where your nose is.

When you train your balance, you’re essentially conditioning your proprioceptors — tiny sensory nerve endings that live in your ligaments and muscles and send information to your brain about where your body is in space — to be even better message transmitters between your brain and your muscles.

Think of walking along the sidewalk and suddenly tripping over an uneven surface. You have only an instant to catch yourself, but a lot is happening in that fraction of a second: Your muscle sensors are sending messages to your brain, which then transmits messages back to your muscles to tell them what to do. To be able to catch yourself before falling, the neural pathways between the brain and the muscles have to be finely tuned so those neurons can very quickly fire and get the message to your muscles. “You really have to train your brain and your muscles together,” says Heather Nettle, MA, coordinator of exercise physiology services for the Cleveland Clinic Sports Health and Orthopaedic Rehabilitation Center.

Unlikely Bedfellows: The Ankle and the Brain
One of the best models we have for this muscle-brain connection is balance and chronic ankle instability. Your ankles and your brain may be at opposite ends of your body, but they are the closest of allies in the balance game. Chronic ankle instability means you’ve had one bad sprain and are now at risk for more sprains, explains Patrick McKeon, PhD, assistant professor for the division of athletic training at the University of Kentucky. One of the reasons you are more likely to experience another sprain, Dr. McKeon continues, is that these injuries can actually damage your proprioceptors. “They can start to send faulty signals to your central nervous system,” he says, meaning that one uneven curb, and you can find yourself back on crutches because your ankle couldn’t reliably tell your brain where your foot was in relation to the ground. “People with chronic ankle instability have to re-establish that connection to the proprioceptors and teach their body how to establish new pathways.”

Exemplifying this point is a 2008 study led by Dr. McKeon, published in the journal Medicine & Science in Sports & Exercise, on recreational athletes (most in their twenties and thirties) with chronic ankle instability and the use of balance training. In addition to such static exercises as balancing on one leg, he had the study subjects perform various combinations of hopping, twisting and jumping, at times in a randomized pattern. “This is more of a real life situation, where you can’t anticipate what’s coming — and that’s when sprains usually happen,” he says.

After four weeks of this balancing and hopping, Dr. McKeon’s group reported significant improvements in balance and sports performance, as well as more confidence in their ankles. The exercises worked, Dr. McKeon thinks, because they challenged the brain and the body together and helped re-establish that pathway so essential to good balance.

Prescription for Proprioception: Get Hopping!